Evaluation of Intra-Tumoral Vascularization in Hepatocellular Carcinomas

Abstract

Intratumoral neovascularization has intricate effects on tumor growth, metastasis, and treatment. Over the last 30 years, Microvessel density (MVD) has been the standard method for laboratory and clinical evaluation of angiogenesis. Hepatocellular carcinoma (HCC) is a typical hypervascularized tumor, and the predictive value of MVD for prognosis is still controversial. According to previous viewpoints, this has been attributed to the determination of hotspot, counting methods, vascular endothelial markers, and different definitions of high and low vascular density; however, the heterogeneity of tumor angiogenesis patterns should be factored. The breakthroughs in artificial intelligence and algorithm can improve the objectivity and repeatability of MVD measurement, thus saving a lot of manpower. Presently, anti-angiogenesis therapy is the only effective systematic treatment for liver cancer, and the use of imaging technology-assisted MVD measurement is expected to be a reliable index for evaluating the curative effect. MVD in multinodular hepatocellular carcinoma represents a subject area with huge understudied potential, and exploring it might advance our understanding of tumor heterogeneity.

Prognostic role of plasma level of angiopoietin-1, angiopoietin-2, and vascular endothelial growth factor in hepatocellular carcinoma

“…Third, this study did not evaluate the plasma levels of these three angiogenesis factors in normal control subjects or cirrhotic patients because we focused on the role of Ang-1, Ang-2, and VEGF as prognostic rather than diagnostic markers. Fourth, this study did not evaluate other valuable angiogenesis markers, such as microvessel density, PDGF/PDGFR, FGF/FGFR, and endoglin (CD105)[ 9 , 31 ]. Further comprehensive studies including these angiogenesis markers are hence needed.…”

An Insight into miR-1290: An Oncogenic miRNA with Diagnostic Potential

“…The better understanding of the molecular basis of this pathology is crucial for the recognition of new molecular targets, treatment decisions and biomarkers [193,194]. HCC is a typical hyper-vascular tumor which uses exosomes enriched in angiogenic factors including miRNAs for cancer progression and metastasis [195]. Recently, it was found that miR-1290 delivered through exosomes from HCC cells to recipient endothelial cells downregulates the suppressor of MEK null (SMEK1) expression and promotes tumor angiogenesis [196].…”

Intratumor Heterogeneity in Hepatocellular Carcinoma: Challenges and Opportunities

“…HCC is a highly vascularized malignancy [ 46 ], but there are conflicting data with regard to microvessel density (MVD) and microvascular invasion (MVI) as predictive indicators for patient prognosis [ 46 , 47 ]. One possible explanation for these discrepant results is that the amount of vascular ITH may influence tumor behavior independent from the degree of MVD or MVI.…”